Ask Dr. Hallberg: Healthy living and memory retention

As millions of baby boomers approach retirement age, medical researchers are exploring how the brain ages and the links between healthy living and memory retention.

MPR medical analyst Dr. Jon Hallberg discussed recent research about memory decline and the middle-aged brain with MPR's Steven John. Hallberg is a physician in family medicine at the University of Minnesota and director of the Mill City Clinic.

An edited transcript of that discussion is below.

Steven John: It is just a fact of life that your mental abilities decline as you get older?

Dr. Jon Hallberg: What we're learning is that some faculties, some abilities, change and decline, but others may stay the same or maybe even improve.

John: What parts of our mental abilities decline, and what parts may improve?

Hallberg: There are new terms that are emerging from some of the studies that are being done, and one of them is fluid intelligence. And that's the sort of stuff of the factual: memorizing names, places, dates. That kind of memory of computational stuff might decline a little bit.

But thankfully there's something called crystallized intelligence, the kind of thing that requires life experience, wisdom, improves. And I think that might actually be why people actually sometimes get more creative as they get older. You're relying on experience, things you've seen, places you've been, people you know. The old adage that there's a certain amount of wisdom that comes with age probably really gets at that.

John: What kind of research is getting done about our diminishing brain abilities as we get older?

Hallberg: There's been a ton of stuff that's been done over the years but maybe the most interesting thing that's happening right now is something they're dubbing the Manhattan Project of middle age. It's this huge study that's called the MIDAS study, and that stands for Midlife in the United States. They've got 7,000 people enrolled from ages 25 to 74. The great thing about this is they're studying these people as the years and the decades go by, so they can actually measure their intelligence, as it were, or the way that their brain is thinking at certain points and then keep following them along.

John: There was a story in the New York Times over the weekend that pointed to education as key to having a sharper brain as we age, why is education so important?

Hallberg: They're talking about education being this elixir that can bring us maybe a healthy body and mind. And why is that? We don't know. We think that has something to do with, as you learn new things there are connections, literal connections being made between neurons that is healthy, that is somehow protective to some of the decline we might otherwise have.

John: What kind of diagnostic tools are available to figure out if it's a serious issue or not?

Hallberg: In the past, and many of us still do this (it's a little misguided), we often will give something called a mini-mental status exam which asks a number of questions. The fact is though, that if you score pretty badly on that you're pretty far along.

So, now we're doing something called the mini-cog, and it's really, really simple. You basically ask somebody to remember three words. You kind of distract them by having them draw a clock face, and you typically have them show the hands on the clock that would say like 11:10. And then you come back and say, 'Can you tell me those three words again.' It's as simple as that. Of course, everyone's now anxious about trying to remember three words. But that's actually very helpful, and if a family member is present we have this family questionnaire we can give that actually helps give us a guide and then we can go a little further into the questionnaire.

John: What advice do you have for patients who may be in decline because they're getting a little older but aren't really experiencing dementia symptoms yet?

Hallberg: This is the ideal place to sort of intervene if we can. That's to make sure that people are doing everything they can simply to keep their mind sharp: so certainly reading widely, being curious, doing stuff.

And then they found that there are some common threads for people who age well and have a good memory. And that is to exercise frequently, to be socially active and connected. Those who remain calm in the face of stress tend to do better, and people who feel like they're in control of their lives. All of these things are sort of interconnected, but that actually seems to make a difference.